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Biomedical subjects

R Tubiana

Publications and source records attributed to R Tubiana.

At least 19 recordsLinked to original sources
PubMed1991

Palmar subluxation of the carpus in rheumatoid disease: a radiological evaluation.

The authors present a radiological assessment of palmar subluxation of the carpus in rheumatoid disease. The radiological measurements have been taken with reference to the long axis of the radius, the radiological centres of the lunate and the capitate and expressing their reciprocal distances as a ratio which we have termed the radio-carpal and inter-carpal indices. Using a control group of a 100 serial radiographs of normal wrists it was possible to determine the normal indices and their normal range. A subsequent analysis of 100 rheumatoid wrists enabled them to accurately determine the degree of anterior carpal subluxation, and allowed this form of radio-carpal malalignment to be differentiated from other forms of carpal instability.

Adult↗
PubMed1991

[Development of the techniques of tendon transfers for radial paralysis].

The techniques of tendon transfer for radial palsy are continually evolving. The technique of R. Merle d'Aubigné partly inspired by that of Robert Jones clearly represented an advance, but a study of the results has shown several imperfections. The techniques of Brand, Tsuge, or Boyes more recently, have also brought improvements, but are not entirely satisfactory. A study of all the elements of tendon transfers schemes leads us to describe two basic schemes for tendon transfers either using F.C.U. or not, which can be adapted to the patient's particular needs. The essential point for success is the centralization of extensor carpi radialis longus at its insertion.

Hand↗
PubMed1990

Technique of dorsal synovectomy on the rheumatoid wrist.

Synovectomy is the basic operation on the rheumatoid wrist. Dorsal synovectomy of the wrist is never performed in isolation. It is always combined with extensor tenosynovectomy, synovectomy of the distal radio-ulnar joint, and surgical stabilization of the wrist. Early wrist synovectomy is ideally performed when the disease is largely confined to the soft tissues and where the overall alignment of the wrist is preserved. Careful reconstruction of the soft tissues following synovectomy is paramount in maintaining or restoring wrist stability. The satisfactory long term results of early wrist synovectomy have encouraged an expansion of the indications particularly to include the more advanced cases. In such cases additional bony surgery can be combined with the synovectomy to allow the realignment and stabilization of the wrist, so avoiding, in the majority of cases, the need for arthroplasty or wrist fusion.

Arthritis, Rheumatoid↗
PubMed1990

Carpal tunnel syndrome: some views on its management.

Despite its high incidence and its reputation for simplicity and efficacy, carpal tunnel release does not invariably produce good results and dissatisfied patients are not infrequently encountered. Unsatisfactory results are due to inaccurate diagnosis and, all too frequently, iatrogenic surgical complications. Surgical technique plays an important role in the achievement of good quality results. Various technical points are controversial and are here discussed: the incision, the division of the retinaculum, neurolysis, repair of the transverse carpal ligament and postoperative management. Our views on the management of recurrence, postoperative sequelae and complications are outlined.

Aged↗
PubMed1989

Restoration of wrist extension after paralysis.

Loss of active extension of the wrist is a major functional handicap for the affected patient. Restoration of wrist extension, primarily accomplished via tendon transfers, is a fundamental part of surgical treatment after paralysis. The anatomy and physiology of the wrist, the clinical aspects, the history, and restorative treatment of wrist extension after paralysis are discussed.

Humans↗
PubMed1976

Palmaris longus, anteductor of the thumb.

Palmaris longus contributes to the anteposition and pronation of the thumb under circumstances. It is however restricted by its medial tendon which runs into the palmar aponeurosis. The diversion of this tendon and the mobilisation of the muscular head of the abductor pollicis brevis arising from its lateral tendon will substantially accentuate the rôle of palmaris longus as a muscle of the thumb.

Humans↗
PubMed1976

[Paralysis of the intrinsic muscles of the hand].

Palliative treatment of intrinsic muscle paralysis aims at correcting the claw deformity and improving prehension. This treatment will vary according to whether the claw can be actively corrected or not, if M. P. hyperextension is blocked. In the first category it suffices to maintain M. P. joint flexion either by capsulodesis or tenodesis so that the long extensors can extend the interphalangeal joints. Tendon transfers are useful only to reinforce the flexion force of the fingers if there is an associated long flexor tendon paralysis. These transfers should be fixed to the proximal part of the proximal phalanx. If the claw is not actively correctable, associated cutaneous, tendinous or joint lesions must co-exist and these will demand priority treatment. Tendon transfers, if possible, aim to extend the distal phalanges and should be fixed distally on the extensor expansion, knowing however that this carries the risk of swan neck deformity.

Hand↗
PubMed1975

Hand reconstruction.

To conclude, one must apologize for having introduced so many subjects and left so many loose ends. Hand reconstruction poses a multitude of problems which are presently in an evolutionary phase. In discussing the notion of hand surgery specialization one draws upon orthopaedic, plastic and microsurgical techniques. But is it not precisely this adaption of diverse techniques to one organ which constitutes a speciality? Rapid progress in hand surgery was achieved the moment surgeons confined the major part of their activities to the treatment of this organ. But let us repeat that progress implies collaboration and not isolation. Advances highlighted in this review resulted mostly from collaboration between the laboratory and the operating theatre. It is worthwhile creating hand centres not only for the benefit of patients but also for research and for training surgeons. These centres must become places of collaboration between numerous clinical and preclinical specialities: namely orthopaedics, traumatology, plastic surgery, rheumatology, neurology, physiotherapy, and applicance makers, as well as biologists and anatomists, all applied to the reconstruction of the hand.

Finger Joint↗